氨磺必利致代谢相关不良反应的影响因素研究

A related study of metabolic side effects in patients with amisulpride

目的探讨精神分裂症患者服用氨磺必利后代谢不良反应的影响因素。方法对48例使用氨磺必利的精神分裂症患者进行了8周的随访研究,在基线及治疗后第4、8周末收集患者的人口学资料、临床资料、体格检查资料(身高、体质量、腹围)、实验室检测资料(血清甘油三酯、胆固醇、高密度脂蛋白、泌乳素水平)以及测定治疗后第4、8周末的氨磺必利血药浓度。结果服用氨磺必利8周后,有12例(25%)患者出现体质量增加>1 kg,体质量增加(2.3±1.9)kg,有2例(4.2%)患者体质量增加≥基线体质量的7%,有7例(14.6%)患者出现血脂异常,未出现血糖异常的患者。体质量增加组比体质量未增加组基线腹围正常的患者比例多(P<0.05)。血脂异常组比血脂正常组患者基线时合并其他抗精神病药物的使用时间较短,病程较短,治疗后第8周末泌乳素水平、基线TG/HDL偏高(P<0.05)。结论精神分裂症患者服用氨磺必利后代谢不良反应与患者体型、泌乳素水平、TG/HDL比、合并其他抗精神病药物等因素有关。

Objective To investigate the related factors of metabolic side effects in schizophrenic patients with amisulpride.Methods A total of 48 schizophrenic patients with amisulpride were selected and examined with basic demographic,clinical and physical examination data（ height,weight,waist circumference）,levels of serum cholesterol,triglycerides,high-density lipoprotein and prolactin at the baseline,the 4～（th） weekend and 8^th weekend of treatment,and examined with plasma concentration of amisulpride at the 4～（th） weekend and 8^th weekend of treatment. Results At the 8^th weekend of treatment,there were 12 patients（ 25%） with weight gain,2 patients（ 4. 2%） having experienced an increase ≥7% of body weight,7 patients（ 14. 6%） with dyslipidemia and no patients with abnormal blood glucose. The proportion of normal waist circumference for the patients in weight-gain group was significantly higher than that in non-weight-gain group（ P〈0. 05）. The duration of taking amisulpride combined with other antipsychotics in patients with hyperlipaemia was significantly less,and duration of illness was significantly less; the level of prolactin at the 8^th weekend of treatment and the ratio of TG / HDL at the baseline were signficantly higher than those in the patients without hyperlipaemia（ P〈0. 05）. Conclusion The metabolic side effects in the schizophrenic patients with amisulpride are related to the fit of the patients,the level of prolactin,the ratio of TG / HDL and prescription of other antipsychotics.